CN103930172B - Before revolving/supination KAFO and method - Google Patents

Before revolving/supination KAFO and method Download PDF

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Publication number
CN103930172B
CN103930172B CN201280052883.XA CN201280052883A CN103930172B CN 103930172 B CN103930172 B CN 103930172B CN 201280052883 A CN201280052883 A CN 201280052883A CN 103930172 B CN103930172 B CN 103930172B
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forearm
wearer
support member
rotary components
rotation
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CN201280052883.XA
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CN103930172A (en
Inventor
P·M·博努蒂
B·P·博努蒂
K·R·鲁霍尔
G·A·菲利普斯
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Bonutti Research Inc
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Bonutti Research Inc
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/01Orthopaedic devices, e.g. splints, casts or braces
    • A61F5/0102Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
    • A61F5/013Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations for the arms, hands or fingers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/01Orthopaedic devices, e.g. splints, casts or braces
    • A61F5/0102Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
    • A61F2005/0132Additional features of the articulation
    • A61F2005/0165Additional features of the articulation with limits of movement

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  • Health & Medical Sciences (AREA)
  • Vascular Medicine (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nursing (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)

Abstract

A KAFO for the supination of wearer's forearm and/or before revolving, described KAFO comprises: base; Upper arm support member, it is connected to base and is configured to make wearer's upper arm to fix; Rotary components, it is connected to base and is included in Plane of rotation with respect to the rotatable output link of base; And forearm support member, it is connected to the output link of rotary components and is configured to engage releasedly wearer's wrist and forearm.

Description

Before revolving/supination KAFO and method
Background technology
The field of the invention relate generally to hand and forearm orthosis. When joint is because of wound or handArt and when injured, conventionally can form due to contracture cicatricial tissue. This situation can limit passThe scope of activities of joint. Conventionally can utilize scope of activities (ROM) KAFO to treat this situation.ROM KAFO is normally used device during Physical rehabilitation is treated, to increase wearer's energyThe scope of activities of movable joint.
Summary of the invention
A kind of supination of the forearm for wearer is provided and/or revolves front KAFO. Described KAFOComprise: base; Upper arm support member, it is connected to base and is configured to make wearer's upper arm solidFixed; Rotary components, it is connected to base and is included in Plane of rotation rotatable with respect to baseOutput link; And forearm support member, it is connected to the output link of rotary components and is configured toEngage releasedly wearer's wrist and forearm.
A kind of supination of the forearm for wearer is provided and/or revolves front KAFO. Described KAFOComprise: base; Upper arm support member, it is connected to base and is configured to engage wearer's upper arm;Rotary components, it is connected to base and is included in Plane of rotation with respect to the rotatable output of baseMember; And forearm support member, it is connected to the output link of rotary components, so that forearm supportsPart is configured to wearer's belemnoid substantially to aim at the Plane of rotation of rotary components.
The orthotic method of a kind of use for the supination of wearer's forearm and/or before revolving is provided.Described method comprises: wearer's upper arm is connected to KAFO; And by wearer's wrist andForearm is connected to orthotic forearm support member, so that the rotation of wearer's belemnoid and rotary componentsPlane is aimed at substantially.
The orthotic method of a kind of use for the supination of wearer's forearm and/or before revolving is provided.Described method comprises: wearer's upper arm is connected to KAFO; By wearer's wrist and forearmBe connected to orthotic forearm support member, so that forearm support member extends to contiguous wearer's wristPosition; And start rotary components to rotate wearer's wrist.
Brief description of the drawings
Fig. 1 is the view of wearer's right forearm.
Fig. 2 is for supination being provided and revolving the exemplary orthotic side isometric view of front rotation.
Fig. 3 is the orthotic substituting side isometric view of Fig. 2.
Fig. 4 is the orthotic phantom of Fig. 2.
Detailed description of the invention
Relate generally to of the present invention is used for the supination of the forearm that wearer is provided and revolves rectifying of front rotationShape device. KAFO provides rotation, so that wearer's upper arm parts is divided the forearm with respect to wearerRotation be secured in place.
Fig. 1 is the view that uses orthotic wearer's arm. Although KAFO can be used for wearingThe person's of wearing right arm or left arm, but Fig. 1 shows wearer's right arm 10. Wearer's armBetween 10 hands 12 wearer and shoulder 14, extend. Wearer's right arm 10 comprises wristPortion 16, bottom or forearm 18, ancon 20 and top 22. Wrist 16 comprises carpal bone 17, itsIt is the region that hand 12 engages with the bottom 18 of wearer's arm 10. Ancon 20 is armsThe region that 10 bottom 18 and the top 22 of arm 10 engage.
The bottom 18 of arm 10 comprises radius 30 and ulna 32. Radius 30 has distal portions40, be formed with processus styloideus radii 42 in the end of distal portions 40. Radius 30 has at anconProximal part 44 or the caput radii of the radius 30 at 20 places. Similarly, ulna 32 has far-endPart 46, is formed with processus styloideus ulnae 48 in the end of distal portions 46. Ulna 32 has at elbowThe proximal part at 20 places of portion or olecranon 50. The bottom 18 of arm 10 also comprises near-end radioulnar passJoint 52 and far-end articulatio radioulnaris 54. The position of processus styloideus radii 42 and ulna shin bone 48 exists substantiallyWrist joint or wrist 16 positions, in this position, hand 12 carry out bending, stretching, extension, interior receipts,Abduction and belt.
Extend between shoulder 14 and ancon 20 on the top 22 of arm 10. The top of arm 1022 comprise humerus 60. Humerus 60 has distal portions or coaster and epiphysis 62,62 points of epiphysisDo not cooperate with the proximal part 44 and 50 of radius 30 and ulna 32. In addition, humerus 60 hasThe proximal part 64 cooperating with shoulder 14.
When rotating hand 12 so that the palmar of hand 12 or front side and wrist 16 face down and handThe opposite side of portion 12 or rear side and wrist 16 when upper, occurred before the revolving of forearm 18. When turningStart portion 12 in case the palmar of hand 12 or front side and wrist 16 towards upper and hand 12 HesWhen the opposite side of wrist 16 or trailing flank are downward, there is the supination of forearm 18. At forearm 18Revolve between early stage, radius 30 is by rotating around near-end articulatio radioulnaris 52 and far-end articulatio radioulnaris 54And intersect with ulna 32. KAFO is connected to wrist 16, forearm 18 at least one of wearerThe top 22 of part and arm 10, arrives radius with isolation before hand 12 revolves and/or during supination30 and the motion of ulna 32.
Fig. 2 and 3 is supination of the arm 10 for the wearer shown in Fig. 1 is provided and revolves frontExemplary orthotic side isometric view. In the exemplary embodiment, comprise can for KAFO 100Discharge and be connected to the base 102 of upper arm support member 104 and have with respect to base 102 along verticalTo the rotary components 106 of central axis 108 that extends past device. Base 102 is via maintenanceDevice 110 is connected to upper arm support member 104 releasedly, and in the exemplary embodiment,Base 102 can be formed by rigid plastic material, and can be formed by any suitable material. ?In exemplary embodiment, holding device 110 can be locking device, and can be bolt andThe form of knob 111, the form of bolt and knob 111 contribute to make upper arm support member 104 withOptionally the locking and unlocking of base 102. Upper arm support member 104 comprises can be positioned at base 102The arm member 112 of top, can be formed in arm member 112 with toilet bowl 114, so that onArm support member 104 can be connected to base 102. Arm member 112 can be by rigid plastic material shapeBecome, and can be formed by any suitable material. In one embodiment, groove 114 can beCardinal principle arc, be formed on upper arm support member 104 and the end to allow upper arm support member 104 to regulateAngle between seat 102. Base 102 comprise with the longitudinal axis aligned in general of base 102 alsoBe in substantially parallel relationship to the maintenance groove 116 of central axis 108, so that upper arm support member 104 slidablyBe connected to base 102, to adapt to the pendant of KAFO 100 of the forearm 18 with different lengthDai Zhe.
Upper arm support member 104 also comprises and is configured to upper arm parts 22 to be fixed to KAFO 100Upper arm cuff 118. During rotation, upper arm support member 104 is by wearer's upper arm parts 22Substantially be fixed to the fixed position with respect to wearer's hand 12. Upper arm cuff 118 is by coverHoop groove 120 is connected to arm member 112 releasedly via cuff keeper 122. At oneIn embodiment, cuff keeper 122 comprises and extends past upper arm cuff 118 and cuff groove 120Bolt (not shown), tighten and fix this bolt by cuff knob 124. Alternatively,Upper arm cuff 118 can be connected to arm member 112 by any suitable holding device. ShowingIn example embodiment, upper arm cuff 118 can be made up of the elastomeric material such as plastics, and comprisesThe upper arm band 126 that is connected to upper arm cuff 118, upper arm band 126 can be configured to allow upper armCuff 118 is fixed on wearer's upper arm in upper arm support member 104 releasedly. SubstitutingProperty embodiment in, upper arm cuff 118 can by substantially stop that upper arm cuff 118 moves relativelyThe material of rigidity is made. Upper arm band 126 comprises can discharge secure component, such as hook and coil component,Be fixed to releasedly upper arm support member 104 with adjustable ground puller strap 126 and by upper arm 22.
Similar with upper arm support member 104, rotary components 106 is connected to base 102 slidably,So that rotary components 106 can be positioned at base 102 tops. Rotary components 106 can be by rigidity plasticsMaterial or other suitable material form. In the exemplary embodiment, rotary components 106 can be throughBe connected to base 102 by holding device 130. Holding device 130 extends past and is formed on rotationGroove in assembly 106 132 and be formed on the hole 134 in base 102. In exemplary embodimentIn, holding device can be locking device, locking device can be to help rotary components 106 HesBase 102 is the bolt of the locking and unlocking and the form of knob 131 optionally. Groove 132 canPerpendicular to the longitudinal axis orientation of base 102, vertically to regulate hand with respect to base 10212 and/or wrist 16.
Rotary components 106 can be configured to rotate forearm 18 around axis 108, and axis 108 is largeBody is at center or the middle outboard shafts of wearer's forearm 18 (in the time being arranged in KAFO 100)In line, extend. In the exemplary embodiment, rotary components 106 can be connected to forearm support member 140,Forearm support member 140 comprises anterior forearm support member 142 and rear portion forearm support member 144. BeforeArm support member 140 can be configured to stretch proximal radius belemnoid 42, processus styloideus ulnae 48 and wearPerson's wrist joint, to provide relative stability and to guarantee forearm 18 and wrist 16 can keep substantiallyIn axis 108. Forearm support member 140 can be configured to substantially stop torque load to be applied inTo the carpal bone 17 of wrist 16, and in the time that rotating in KAFO 100, forearm 18 substantially hindersOnly wrist 16 stretches and/or is bending. The basic wrist 16 that stops stretches during forearm 18 rotationsAnd/or bending contribute to reduce to act on wrist 16 and hand 12, be greater than forearm 18Load.
In the exemplary embodiment, anterior forearm support member 142 and rear portion forearm support member 144Can be linked together via underarm band 141, underarm band 141 is around by being formed on anterior forearmGroove 143 in support member 142, thus forearm support member can be configured in the 18 rotation phases of forearmBetween forearm 18 is fixed in forearm support member 140. In the exemplary embodiment, underarm band141 can be connected to forearm support member 140, and contiguous processus styloideus radii 42, processus styloideus ulnae 48 and wrist closeJoint. Contiguous processus styloideus radii 42, processus styloideus ulnae 48 and wrist joint connect forearm support member 140 to be hadHelp substantially stop wrist 16 to stretch and/or bending during hand 12 rotations.
In one embodiment, underarm band 141 comprises secure component, such as hook and coil component,To be with 141 can be adjustable and can be tightened up above hand 12 and forearm 18.In the exemplary embodiment, forearm support member 140 can be formed and be wrapped by plastics or other materialDraw together liner each inwall in anterior forearm support member 142 and rear portion forearm support member 144Padded coaming so that wearer is comfortable.
By forearm support member 140 being connected to the inwall 150 being formed in swing pinion 152,Rotary components 106 can be connected to forearm support member 140. In the exemplary embodiment, rotationGear 152 has curved profile shape substantially, so that forearm 18 rotates. In exemplary embodimentIn, can utilize screw rod and nut fixed system that forearm support member 140 is connected to inwall 150,But can use any coupling arrangement that forearm support member 140 is connected to inwall 150. SubstitutingGround, forearm support member 140 can be integrally formed on swing pinion 152.
Swing pinion 152 comprises the gear teeth arcuate array 156 of the configuration with part circle. BeforeArm support member 140 upwards extends and warp between the opposite end 155 of gear teeth arcuate array 156Cross a part for the opening 158 being formed in swing pinion 152. Gear teeth arcuate array 156Restriction can perpendicular to and/or be orthogonal to the Plane of rotation 160 of axis 108. Forearm support member 140Can be connected to rotary components 106 so that, in use, wearer's processus styloideus radii 42 and/Or processus styloideus ulnae 48 is positioned at Plane of rotation 160. By processus styloideus radii 42 and/or processus styloideus ulnae 48Aim at Plane of rotation 160 and contribute to substantially to stop wrist 16 to stretch during forearm 18 rotationsExhibition and/or bending.
Swing pinion 152 can be connected to driven wheel 162 (shown in Figure 4), driven wheel162 can connect regularly with driving shaft 164 and drive knob 166, so that driven wheel 162Can engage with the tooth arcuate array 156 on swing pinion 152. In the exemplary embodiment, driveMoving gear 162 can be gear on worm. In an alternative embodiment, driven wheel 162 canIt is motor. Alternatively, driven wheel 162 can be that the forearm 18 that affects wearer rotatesAny gear. When drive knob 166 rotates, can make driven wheel 162 rotate to affect forearm18 revolve front and/or supination.
During operation, in the exemplary embodiment, make the close end of radius 30 and ulna 32Points 44 with the bodily tissue of 50 viscoelasticities that are connected with the humerus 60 in wearer's arm 10Can need to stretch so that wearer's forearm 18 before revolving and/or supination time motion through expectingScope of activities. When the glutinous bullet being connected with the proximal part 44 and 50 of radius 30 and ulna 32When property bodily tissue is stretched, the top 22 of wearer's arm 10 is positioned at orthotic upper armIn cuff 118. Can be tightened up around the top of arm 10 22 with 126, with respect to wearingThe top 22 of person's arm 10 is decided to be arm member 112.
Can be by hand through the opening 158 in forearm support members 140 by hand 12 is moved12 are decided to be in forearm support member 140. Then, be with 141 can be tightened up and be fixed into contiguous wristJoint, so that the side wall and pressure of forearm support member 140 leans against the palmar of hand 12 and the back side, wrist16 and forearm 18, so as at least one in processus styloideus radii 42 and processus styloideus ulnae 48 can with rotationPlane 160 is aimed at substantially. Once can being decided to be at forearm, hand 12, wrist 16 and forearm 18 prop upIn support member 140, the bending and/or stretching, extension of wrist 16 just can be prevented from substantially.
The bottom 18 of wearer's arm 10 and top 22 can relative to each other keep motionless, untilRotary components 106 activated or starts. Therefore, the bottom 18 of arm 10 can be propped up by forearmSupport member 140 keeps motionless with respect to base 102. The top 22 of arm 10 can be by upper arm coverHoop 118 keeps motionless with respect to arm member 112.
In order to affect before the revolving of forearm 18, can rotate in the counterclockwise direction revolving of rotary components 106Button 166. Being rotated counterclockwise of knob 166 causes that driven wheel 162 rotates around axis 108Swing pinion 152. In the time rotating, the anterior forearm support member 142 of forearm support member 140With rear portion forearm support member 144 fixing hand 12, wrist 16 and forearm 18, substantially to stopTorque load acts on carpal bone 17 and basic prevention wrist joint is bending and/or stretching, extension, and permitsThe distal portions 40 of being permitted radius 30 and ulna 32 with 46 together with forearm support member 140 aroundAxis 108 rotates.
In the time that forearm support member 140 rotates around axis 108, radius 30 and ulna 32 nearEnd part 44 and 50 is moved with respect to the distal portions 102 of humerus 60. The near-end of ulna 32Part 50 is connected with the distal portions 102 use joints of humerus 60. Given by forearm support member 140The rotary moveable that gives the distal portions 40 and 46 of radius 30 and ulna 32 can be blocked to be wornRegion between ancon 20 and wrist 16 in person's arm 10. When driven wheel 162 rotatesTime, swing pinion 152 and forearm support member 140 can be around axis 108 along clockwise directionPlay rotation, and the revolving front degree and can be increased of forearm 18.
Make the direction of rotation of knob 166 oppositely can make driven wheel 162 and swing pinion 152 revolveTurn to forearm support member 140 is moved, thereby reduce the front degree of revolving of forearm 18. Rotation groupPart 106 can be manipulated into by being rotated in a clockwise direction knob 166 increases revolving of forearm 18Rear degree. Because forearm support member 140 and swing pinion 152 can rotate in the counterclockwise direction,Therefore the supination degree of forearm 18 can be increased. In the time that forearm 18 rotates, forearm support member 140Anterior forearm support member 142 and rear portion forearm support member 144 make hand 12, wrist 16 andForearm 18 is fixing, substantially to stop torque load to act on carpal bone 17 and the basic wrist pass that stopsBending and/or the stretching, extension of joint. Rotation forearm 18, anterior forearm support member 142 and rear portion forearm prop upThe distal portions 40 and 46 that support member 144 allows radius 30 and ulna 32 around axis 108 withForearm support member 140 rotates together and causes radius 30 and ulna 32 with respect to ancon 20 placesHumerus 60 moves.
This printed instructions utilizes example to disclose embodiments of the invention, comprises best enforcement sideFormula, and make any person skilled in the art can put into practice embodiments of the invention, comprise systemMake and use any device and system and carry out any method being included. Of the present invention authorizingThe scope of patent right is defined by the claims, and can comprise its that those skilled in the art expectIts example. This writes other example and is intended within the scope of the claims, if they have withThe identical structural detail of literal language of claim, or as long as they comprise and claimLiteral language there is no the equivalent structure element of actual variance.

Claims (10)

1. the KAFO for the supination of wearer's forearm and/or before revolving, described KAFO bagDraw together:
Base;
Upper arm support member, it is connected to base and is configured to make wearer's upper arm to fix;
Rotary components, it is connected to base and is included in Plane of rotation rotatable with respect to baseOutput link; And
Forearm support member, it is connected to the output link of rotary components and is configured to connect releasedlyClose wearer's wrist and forearm, wherein, described forearm support member is configured to wearer's stemDash forward and substantially aim at the Plane of rotation of described rotary components.
2. KAFO according to claim 1, wherein, described forearm support member is connected to and revolvesWearer's processus styloideus ulnae turns assembly, so that can be aimed at substantially with the Plane of rotation of rotary components.
3. KAFO according to claim 1, wherein, described forearm support member is connected to and revolvesWearer's processus styloideus radii turns assembly, so that can be aimed at substantially with the Plane of rotation of rotary components.
4. KAFO according to claim 1, wherein, described forearm support member is configuredStop the load higher than the load on wearer's forearm to act on wrist and hand for basic.
5. the orthotic method of use for the supination of wearer's forearm and/or before revolving, instituteThe method of stating comprises:
Wearer's upper arm is connected to KAFO;
Wearer's wrist and forearm are connected to orthotic forearm support member, so that wearerBelemnoid is aimed at substantially with the Plane of rotation of rotary components; And
Start the wrist of rotary components with rotation wearer.
6. method according to claim 5, wherein, starts rotary components with rotation wearerForearm also comprise start rotary components so that wearer's forearm supinated.
7. method according to claim 5, wherein, starts rotary components with rotation wearerForearm also comprise and start rotary components so that before wearer's forearm revolves.
8. method according to claim 5, wherein, is connected to forearm by wearer's forearmSupport member also comprises wearer's forearm is connected to forearm support member so that wearer's processus styloideus ulnaeSubstantially aim at the Plane of rotation of rotary components.
9. method according to claim 5, wherein, is connected to forearm by wearer's forearmSupport member also comprises wearer's forearm is connected to forearm support member so that wearer's processus styloideus radiiSubstantially aim at the Plane of rotation of rotary components.
10. method according to claim 5, wherein, is connected to wearer's forearmForearm support member also comprises wearer's forearm is connected to forearm support member substantially to stop than pendantThe high load of load on the person's of wearing forearm acts on wrist and hand.
CN201280052883.XA 2011-09-14 2012-09-14 Before revolving/supination KAFO and method Active CN103930172B (en)

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US13/232,337 2011-09-14
US13/232,337 US8708939B2 (en) 2011-09-14 2011-09-14 Pronation/supination orthosis and method
PCT/US2012/055406 WO2013040350A1 (en) 2011-09-14 2012-09-14 Pronation/supination orthosis and method

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CN103930172A CN103930172A (en) 2014-07-16
CN103930172B true CN103930172B (en) 2016-05-04

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WO2013040350A1 (en) 2013-03-21
CN103930172A (en) 2014-07-16
US10219933B2 (en) 2019-03-05
US20140194799A1 (en) 2014-07-10
US20130066248A1 (en) 2013-03-14
US8708939B2 (en) 2014-04-29
US20160120682A1 (en) 2016-05-05
US9259344B2 (en) 2016-02-16

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